Abstract:
Objective: To describe HIV testing uptake and prevalence among
adolescents and adults in a home-based HIV counseling and testing
program in western Kenya.
Methods: Since 2007, the Academic Model Providing Access to
Healthcare program has implemented home-based HIV counseling and
testing on a large scale. All individuals aged $13 years were eligible
for testing. Data from 5 of 8 catchments were included in this analysis.
We used descriptive statistics and multivariate logistic regression to
examine testing uptake and HIV prevalence among adolescents (13–18
years), younger adults (19–24 years), and older adults ($25 years).
Results: There were 154,463 individuals eligible for analyses as
follows: 22% adolescents, 19% younger adults, and 59% older adults.
Overall mean age was 32.8 years and 56% were female. HIV testing
was high (96%) across the following 3 groups: 99% in adolescents,
98% in younger adults, and 94% in older adults (P , 0.001). HIV
prevalence was higher (11.0%) among older adults compared with
younger adults (4.8%) and adolescents (0.8%) (P , 0.001). Those
who had ever previously tested for HIV were less likely to accept
HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05
to 0.07) but more likely to newly test HIV positive (adjusted odds ratio:
1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated
with testing uptake and HIV prevalence, particularly, gender,
relationship status, and HIV testing history.
Conclusions: Sociodemographic and socioeconomic factors were
independently associated with HIV testing and prevalence among the
age groups. Community-based treatment and prevention strategies
will need to consider these factors
